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February 2019
Revenue
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Revenue by Region ?
Revenue performance was relatively mixed across different regions. The West experienced the greatest decrease in NPSR per Adjusted Discharge, and was middle-of-the-pack relative to NPSR per Adjusted Patient Day. As mentioned in the volume section, the West also experienced the greatest decrease in Average Length of Stay, which—coupled with these revenue findings—indicates the potential impact of more bundled payments that may be occurring in the West. The Great Plains region experienced the largest decrease in Bad Debt and Charity Care, mirroring some of the same trends observed with the 0-25 bed-size cohorts due to a high number of small hospitals in that region.
NPSR per Adj. Discharge
NPSR per Adj. Patient Day
IP/OP
Bad Debt and Charity
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
National Revenue Observations
Revenue performance was strong in January. All indicators performed favorably compared with January 2018, and only a few indicators were below budget expectations. NPSR per Adjusted Discharge and Patient Day had similar increases of about 1-1.5 percent, but both remained under budget expectations by about 2 percent. This reflects optimism in the budgeting that was not fully realized. The Inpatient/Outpatient (IP/OP) factor continued its upward shift, rising 4 percent from January 2018. This has wide implications for all hospitals, as more and more services move to outpatient settings. Bad Debt and Charity Care also experienced a favorable decrease, but again, not to the level that was budgeted.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
NPSR per Adj. Discharge
(2.0%)
1.6%
1.0%
npsr_per_adj_discharge.svg
NPSR per Adj. Patient Day
(1.8%)
(3.1%)
1.5%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
0.7%
(0.7%)
4.1%
ip_op.svg
Bad Debt and Charity as a % of Gross
1.9%
(3.8%)
(1.3%)
bad_debt.svg
Unless noted, figures are Actuals and Medians
By Region
By Bed Size
National Observations
Revenue by Bed Size
Revenue performance reflected national trends across most bed-size cohorts, with generally favorable performance in January. Hospitals with 0-25 and 200-299 beds saw the greatest year-over-year declines in NPSR per Adjusted Patient Day. The largest hospitals demonstrated the strongest year-over-year growth in NPSR per Adjusted Patient Day—a welcome change for that cohort compared with December. The smallest hospitals also experienced the greatest year-over-year increase relative to IP/OP factor, once again demonstrating their risk as more services transition to outpatient settings.
NPSR per Adj. Discharge
NPSR per Adj. Patient Day
IP/OP
Bad Debt and Charity
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
By Region
By Bed Size
National Observations
©2018 Kaufman, Hall & Associates, LLC
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